Physiotherapy advice after Gynaecology Surgery Exceptional healthcare, personally delivered
First day after operation You may spend most of the day in bed. It is a good idea to take 3 deep breaths (whenever you are awake) every hour. This may help if you feel nauseous and will help regain normal breathing. Coughing n If you have an abdominal wound you need to support it n In bed: bend both knees up with feet flat on the bed and support the wound gently but firmly with your hands n Sitting: lean slightly forward to relax abdominal muscles and again support the wound with your hands and/or pillow n If you have had vaginal surgery, put your hand over the pad and support the perineum when coughing Getting out of bed n Bend knees up one at a time n Keep knees together, roll onto your side n Push up into sitting position using your arms. At the same time, lower legs over the side of the bed Circulation Regular movement of legs is essential while you are not as active as you usually are. Move your feet up and down at the ankles for 30 seconds every half hour when you are in bed or sitting in a chair. You will also be given support stockings to wear. Remember; although it is important to mobilise early do not do too much. A balance must be achieved between exercise and rest. Learn to listen to your body! 2 Physiotherapy advice after Gynaecology Surgery
Exercises Note: You should start gently and stop if it hurts. Try again a few days later. Pelvic floor exercises The pelvic floor muscles support the pelvic organs, back passage, vagina and the opening from the bladder (urethra). Pelvic floor exercises can be done anytime, anywhere. To help you remember, try to associate it with a regular activity. Wait until the catheter is removed before starting the exercises. Sitting comfortably ntighten your back passage (as if controlling wind), vagina and front passage (urethra) n(i) Lift and hold for 5-10 seconds, as you are able, repeat 5-10 times nlift and release quickly 5-10 times nrepeat these exercises 3 times during the day Abdominal exercise (deep core muscle) Lying on your back, let your tummy relax, breathe in gently. As you breathe out gently pull in the lower part of your tummy, hold for 5 seconds, and repeat 5 times. Do not move your back. You should be able to breathe and talk while exercising. This can also be done in sitting or standing. Pelvic tilting Lie on your back with your knees bent. Pull your tummy in and flatten your back onto the bed. Hold, then relax. Do not hold your breath. Repeat 5-10 times twice daily. (If you have trapped wind, this exercise may help to release it.) Physiotherapy advice after Gynaecology Surgery 3
General guidelines The following activities should be avoided for at least 6 weeks following surgery: n Vacuuming npegging out heavy washing nheavy shopping ncarrying/lifting heavy objects nstanding ironing for long periods Tiredness Expect to feel tired - you have had an operation - get as much rest as you can. Avoid going up and down stairs too frequently for the first few weeks. Driving Do not drive until you are confident you can do an emergency stop. If you have abdominal surgery we advise you not to drive for at least 4-6 weeks (check with your insurance company). Walking The first time you go out do not go too far! Listen to your body. Build up your walking distance gradually. Sex It is advisable to avoid intercourse for the first 6 weeks following surgery. If concerned, discuss with your GP. Progression of exercises Wait for 6 weeks to allow healing before progressing to lowimpact exercise (e.g. swimming, cycling, Pilates, yoga). Avoid high-impact activities (e.g. running, tennis, high-impact aerobic classes) and competitive sports for at least 3 months. Avoid straining when opening your bowels. It will help to put your feet up on a low stool and relax your abdominal muscles. 4 Physiotherapy advice after Gynaecology Surgery
References Haslett, S et al (2003, 5th ed) Hysterectomy, vaginal repair and surgery for stress incontinence. Beaconsfield: Beaconsfield Publishers Ltd. NHS Constitution. Information on your rights and responsibilities. Available at www.nhs.uk/aboutnhs/constitution Physiotherapy advice after Gynaecology Surgery 5
How to contact us: Southmead Hospital Bristol 0117 323 5050 Day Assessment Unit 0117 323 6397 Central Delivery Suite 0117 323 5320 St Michael s Hospital, Bristol Day Assessment Unit 0117 928 5395 Delivery Suite 0117 928 5214 Royal United Hospital, Bath Day Assessment Unit 01225 824 447 or 01225 824 847 www.nbt.nhs.uk If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice. North Bristol NHS Trust. This edition published February 2015. Review due May 2017. NBT002353